Can Video Head Impulse Testing Be Used to Estimate the Involved Canal in Benign Paroxysmal Positional Vertigo?

Area of Science:

• Vestibular System Disorders
• Neurology
• Otolaryngology

Background:

• Benign paroxysmal positional vertigo (BPPV) diagnosis can be challenging, especially with subtle presentations.
• Accurate canal identification and treatment effectiveness assessment are crucial for managing BPPV.
• Patient-reported outcomes, such as those from the Dizziness Handicap Inventory, are valuable adjuncts.

Purpose of the Study:

• To evaluate the utility of video head impulse testing (VHIT) in diagnosing the affected canal in BPPV.
• To assess the role of VHIT in measuring treatment efficiency for BPPV.
• To compare treatment outcomes using the Dizziness Handicap Inventory.

Main Methods:

• Included patients diagnosed with posterior or lateral canal BPPV.
• Performed VHIT before and one week after treatment, analyzing vestibulo-ocular reflex (VOR) gains and correction saccades.
• Compared pre- and post-treatment Dizziness Handicap Inventory scores.

Main Results:

• VHIT did not show significant differences in VOR gains for the involved canal in posterior canal BPPV compared to other ipsilateral canals.
• No significant difference was found between the involved horizontal canal and the contralateral horizontal canal in lateral canal BPPV.
• Patients with lateral canal BPPV demonstrated greater improvement post-treatment compared to those with posterior canal BPPV.

Conclusions:

• Video head impulse testing is not suitable for determining the specific canal involved in BPPV.
• VHIT can be a useful tool for evaluating the effectiveness of BPPV treatment, especially for lateral canal cases.
• Further research may explore VHIT's role in conjunction with other diagnostic tools.